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Home Health & Hospice Week

Diagnosis Coding:

Don't Let These Coding Deletions Make You Tense

Published on Mon Oct 04, 2010

Capture those 3 case mix points with better coding. You should hone your coding of conditions related to the two eliminated hypertension codes to earn your rightful reimbursement under home health prospective payment system. The Centers for Medicare & Medicaid Services defends its decision to eliminate the hypertension codes from the case mix calculation. "The two codes 401.1 and 401.9 are not associated with additional resource use," the rule explains. "Therefore, we believe that the two codes should be removed from our case-mix system." The codes used to be associated with additional resources back when the prospective payment system was first created. But after CMS made PPS refinements in 2008 resulting in the 153-group case mix model, hypertension prevalence more than doubled compared to 2005 levels, CMS points out. The reason the codes now don't indicate resource usage may be because they are used much more often for less severe [...]
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